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Biomedical subjects

L Trojan

Publications and source records attributed to L Trojan.

17 recordsLinked to original sources
PubMed2005

[Relevance of the neuroendocrine differentiation in prostatic carcinoma].

BACKGROUND: NE tumor cells are present in virtually all prostatic adenocarcinomas. As they express no androgen receptor they are hormone independent. During anti-androgenic therapy their number increases. Their prognostic value is controversial. MATERIAL AND METHODS: In 233 patients with prostatic carcinoma the NE differentiation was determined in a hot spot (7.9 mm(2)) with maximum CgA positive cell density. A high NE differentiation (HNE) was defined by a least 30 NE tumor cells, while less means a low NE differentiation (LNE). In addition the occurrence of NE tumor cells was defined as solitary or clustered (> or =5 NE tumor cells in close proximity). RESULTS: In advanced and high grade tumors more and clustered NE tumor cells could be found than in low grade and organ confined tumors. Moreover HNE tumors and occurrence of NE clusters resulted in a significant shorter progression-free interval. CONCLUSIONS: Besides the quantity of NE differentiation the quality of the growth pattern of NE tumor cells is of relevance in prostatic carcinoma.

Adenocarcinoma↗
PubMed2005

[Current aspects of stone therapy].

More than 30 % of all admissions to an urologic clinic are for the treatment of urinary stones. In almost all cases, the treatment is minimally invasive employing extracorporeal shock wave lithotripsy (ESWL), ureterorenoscopy (URS) or percutaneous nephrolithotomy (PCNL). Technical advances in endourology and a growing expertise in ESWL led to a decline in ESWL and an increase in endoscopic techniques. In comparison with ESWL, the endoscopic techniques are more invasive but in most cases achieve a stone free state faster. With the introduction of diagnosis related groups (DRG), the economic aspect of stone therapy is gaining in importance. Stone prevention leads to a cost reduction in the health care system, justifying the use of an appropriate stone metaphylaxis. This review article presents the current recommendations for interventional urinary stone therapy and lists the options of conducting both medical and economically rational therapy.

Cost Control↗
PubMed2003

[Established and new urological therapeutic options in the management of prostate carcinoma].

The surgical and medical management of carcinoma of the prostate is a central issue in urology. Radical prostatectomy is the standard procedure in the curative therapy of locally confined carcinoma of the prostate. Recently, alternative minimally invasive options such as brachytherapy and the still experimental focused ultrasound and cryotherapy have gained in interest. Further palliative schemes such as hormonal ablation and chemotherapy have become established in the management of locally advanced and generalized carcinoma or elderly patients. It was our objective to give an account of these established and new urological therapy options in the management of carcinoma of the prostate.

Aged↗
PubMed2003

[Detection of prostate carcinomas with T1-weighted dynamic contrast-enhanced MRI. Value of two-compartment model].

AIM: The suitability of dynamic parameters of the two-compartment model for detecting prostate carcinomas and its correlation with tumor microvascular density were evaluated. METHODS: The study included 43 patients with biopsy-proven prostate carcinoma: 28 were examined by 1.0-T MRI (Turbo-FLASH) and 15 by 1.5-T MRI (FLASH) with infusion of 0.1 mmol/kg Gd-DTPA. Signal time curves were parametrized with an open two-compartment model in amplitude and exchange rate constants (k(ep)). The microvascular density of resected prostate carcinomas was determined. RESULTS: The microvascular density in the tumors was significantly higher than in the adjacent healthy prostate tissue and correlated in both sequences with k(ep). Prostate carcinomas of the peripheral zone were demarcated by amplitude and k(ep). In the Turbo-FLASH sequence there was a significant difference between the tumor tissue and healthy peripheral zone in terms of k(ep) and in the FLASH sequence in terms of amplitude. CONCLUSION: Prostate carcinomas can be visualized with dynamic T1-weighted MR sequences using a two-compartment model. Moreover, the parameter k(ep) reveals the microvascular density in the tumor and can thus provide valuable clinical information for characterizing the tumors.

Biopsy↗
PubMed2003

Gene delivery into prostate cancer cells by holmium laser application.

New approaches to treat prostate cancer (PCA) are utilizing gene therapy and aim to correct the disease at the genetic level. Getting a gene efficiently into the target cell is the subject of much interest. We used a holmium laser for transfecting rat PCA cells with the reporter gene pEGFP. By FACS analysis and fluorescence microscopy, we could demonstrate that cellular delivery of plasmid DNA was possible with high efficiencies up to 41.3%. Therefore, transfection of PCA cells by holmium laser might offer a promising new gene transfer strategy to PCA with minimal invasiveness.

Adenocarcinoma↗
PubMed2003

Prostate cancer transfection by acoustic energy using pEGFP-N1 as reporter gene in the solid Dunning R-3327-MatLu tumor.

BACKGROUND: Gene therapy is expected to play a major role in medical treatment in the future. Several different methods for DNA transfection exist. We evaluated the efficacy and effects of transfection by acoustic energy in a standardized prostate cancer model. METHODS: Subcutaneous implantation of Dunning tumors was followed by injection of pEGFP-DNA plasmid. Tumors were treated by acoustic energy with different parameter settings and the transfection rate was assessed by FACScan. RESULTS: Standardized experimental conditions resulted in minor intragroup deviations. Intratumoral injection resulted in a transfection rate of 0.3% (control group). The statistically significant increase of 4.6% in cell transfection rate was gained by applying acoustic energy. CONCLUSIONS: DNA transfection of solid tumors can be mediated by the application of acoustic energy. Achieved transfection rates are encouraging and imply therapeutical levels. Prodrug activation or suicide gene therapy are possible fields of investigation in the treatment of prostate cancer.

Acoustics↗
PubMed2003

Rotoresect for bloodless transurethral resection of the prostate: a 4-year follow-up.

OBJECTIVE: To report the results and long-term follow-up of transurethral resection of the prostate (TURP) with a new resection device, the Rotoresect (Karl Storz, Tuttlingen, Germany). PATIENTS AND METHODS: Most endoscopic resection techniques for benign prostatic tissue aim for high ablation rates and minimal bleeding. Available resection electrodes are effective, but cause high blood loss (loop electrode), or less bleeding but poorer ablation rates (electrovaporization). To resolve these conflicts the Rotoresect was developed in 1995; it consists of a specially designed rotating resection electrode, driven by a micromotor, and a high-frequency current to enable simultaneous coagulation, vaporization and mechanical tissue removal during resection. To date, 84 patients with benign prostatic hyperplasia have had their prostate resected with this device (mean prostate size 46.0, sd 18.4 mL) and have been assessed for up to 4 years. RESULTS: During resection there was very little bleeding, with no significant changes in haemoglobin or sodium levels. The mean (sd) duration of catheterization was 1.4 (1.1) days; the urinary peak flow rate was improved from 9.7 (3.2) to 24.2 (8.23) mL/s and the residual urine volume reduced from 187.3 (109.6) to 22.7 (19.5) mL. The International Prostate Symptom Score and quality-of-life index were both improved, from 24.0 (7.5) to 4.1 (2.7), and 4.2 (3.2) to 0.8 (0.9), respectively. Overall the results were stable during the 4 years of follow-up. CONCLUSION: The Rotoresect combines the advantages of standard resection (high ablation rate) by actively rotating the resection electrode, and the haemostatic effect of electrovaporization (minimal blood loss) by simultaneous tissue coagulation and vaporization.

Aged↗
PubMed2003

[Long-term follow-up of interstitial laser coagulation in the treatment of benign prostatic hyperplasia].

INTRODUCTION: Besides standard open or transurethreal adenoma resection, less morbid interstitial laser coagulation (ILC) is an alternative therapeutical option that could reduce lower urinary tract symptoms, especially in high-risk patients. Although short-term results indicate effectiveness, reliable long-term statistics are still lacking. Therefore, to assess long-term satisfaction and overall success rate, we re-evaluated patients with a mean follow-up of 7 years after laser treatment. METHODS: A total of 72 patients had been included in our ILC programme between 1993 and 1995. Mean age was 74 years. About 45 % of the patients had since died of other causes. In all, 23 patients were evaluated by telephone questionnaire, International Prostate Symptom Score (IPSS), Quality of Life (QoL), second surgical interventions or medical therapy. Our patient group was treated with interstitial Nd:YAG laser coagulation (mediLas fibertom). A perineal (34 %), transurethral (23 %) or combined (43 %) approach was chosen, depending on the preoperative volume of the prostate (range 40 - 100 ml; mean 59.3 ml). RESULTS: 68.4 % of the patients were satisfied with their current urological situation. Mean IPSS was 8.8 vs. 18.8 preoperatively mean QoL 1.5 vs. 3.3. 15.8 % had undergone conventional transurethral prostatic resection in the interim; one patient uses a urine catheter. 15.8 % receive medical treatment for lower urinary tract symptoms. CONCLUSIONS: Although the results of standard TUR or open surgery imply higher success, the long-term results of ILC demonstrate effectiveness. Further follow-up studies on a larger number of patients are advisable. The low morbidity of ILC makes this procedure an interesting alternative option in the treatment of high risk patients.

Aged↗
PubMed2003

[Minimally-invasive therapy of urinary stones].

Open surgery was the standard therapy for urinary calculi up to about 30 years ago. This changed upon introduction of extracorporeal shockwave lithotripsy (ESWL) in 1980, a procedure that is now the primary therapy for 70 % of the patients in western countries. Simultaneously, endourological procedures like ureterorenoscopy (URS) and percutaneous nephrolithotripsy (PCNL) have been improved, and now, modern small diameter and highly efficient instruments offer an ideal alternative to shockwave lithotripsy. Today, minimally-invasive stone treatment has replaced open stone surgery almost completely. This article introduces ESWL, URS and PCNL and discusses indications, outcomes and limitations.

Follow-Up Studies↗
PubMed1993

Developing trusting, caring relationships: home care nurses and elderly clients.

Trusting as an area of research has not been critically examined in nursing research literature. In this study, nurses working in home care and elderly clients were interviewed to ascertain the process of developing a trusting relationship. Data were obtained from seven home care nurses and six elderly clients who were interviewed from one to three times. The data were analysed using grounded theory methodology and sorted using Microsoft Word software on a Macintosh computer. The core category which was identified in the data was labelled 'trusting, caring relationships'. This core category encompassed trusting which is developed and the caring which the nurses provide. Home care nurses and elderly clients moved through four phases: initial trusting; connecting; negotiating; and helping. The findings have implications for novice nurses working with elderly people, as well as for programme development and education. More research needs to be done on trust in different contexts to assist all nurses in establishing nurse-client relationships.

Aged↗
PubMedDate not supplied

Acknowledging preceptors: not an easy task.

Educators commonly discuss the need to reward nurse preceptors. A survey of 295 preceptors teaching nursing students found 118 nurses (36.6%) did not feel a reward was appropriate, while the remainder felt it was. When asked if they had enough support, 68 (22.9%) reported "no" and 213 (73%) reported "yes." Recommendations stemming from this research include: the need to redefine "reward" to be more congruent with the preceptor's perceptions; to provide acknowledgment to preceptors reflective of their educational and professional role; and to recognize that the ongoing communication and feedback with nursing faculty is a crucial factor in preceptors' perceptions of support.

Adult↗
PubMedDate not supplied

IGF-I triple helix strategy in hepatoma treatment.

BACKGROUND/AIMS: To investigate the effect of gene therapy for hepatocellular carcinoma based on inhibition of cellular IGF-I expression, the technique of IGF-I triple helix was investigated in mice developing programmed hepatoma. METHODOLOGY: mhAT1F1 mouse hepatoma cell line was transfected in vitro with IGF-I triple helix expression vector (pMT-AG-TH) or with IGF-I antisense expression vector (pMT-Anti-IGF-I). 10 x 10(6) transfected cells of either triple helix or antisense type were inoculated intraperitonealy into transgenic ATIIITB6 mice developing genetically programmed hepatoma (mice die between the age of 6 and 7 months). In parallel, human cell cultures established from surgically removed hepatomas were investigated. RESULTS: mhAT1F1 and human primary cell cultures, transfected with pMT-AG-TH or pMT-Anti-IGF-I vectors resulted in total inhibition of IGF-I demonstrated by immunocytochemical and Northern blot techniques. Transfected cells changed their phenotype and recovered major histocompatibility complex I expression showed by fluorescence-activated cell sorting analysis and Western blot. Moreover, two phenomena were observed in IGF-I "antisense" or "triple helix" transfected cells: 1) the apoptosis, demonstrated by TUNEL technique; 2) the presence of IL-6 simultaneously with disappearance of tumor necrosis factor-alpha and IL-10, investigated by reverse transcriptase-polymerase chain reaction technique. In in vivo experiments, injection of murine transfected cells into mice in terminal-phase prolonged their survival 3-4 months in 100% of cases, as well in "antisense" group (8/8) as in "triple helix" group (10/10). CONCLUSIONS: Injection of hepatoma cells transfected with IGF-I triple helix expression vector, and showing immunogenic and apoptotic characteristics, can constitute an effective cellular therapy against hepatocellular carcinoma.

Animals↗
PubMedDate not supplied

A framework for planned change: achieving a funded PhD program in nursing.

This paper describes a process of planned change undertaken by a group of graduate nursing students of the University of Alberta. Their goal, a funded PhD program in Nursing, was realized fourteen months after their initial meeting. The message of their story is a simple yet significant one for all nurses who wish to influence their environment: Using a framework of planned change, a group of people who organize and commit themselves to a clear goal can become impossible to ignore. In the complexities and uncertainties of today's health care system, many nursing leaders wonder how to effectively insert themselves into the changes occurring in their environments. In this paper, the process of planned change is described through the story of one group of nurses who deliberately set out to reach a desired goal: a funded PhD Program in Nursing at the University of Alberta. Fourteen months later on December 21, 1990, a funded PhD Program in Nursing became a reality. In the early 1980's, several nurses attempted to establish doctoral education for nurses in Canada. The need was for nurse researchers and leaders with doctoral qualifications within the Canadian context. By 1986, the collaboration of nursing faculties at the University of Alberta in Edmonton and the University of Calgary was well under way. The work of Dr. Shirley Stinson, Dr. Janetta McPhail, and Dr. Margaret Scott-Wright with their colleagues resulted in academic approval for the first PhD Program in Nursing in Canada, at the University of Alberta in Edmonton. The starting date of the program, however, was subject to the availability of funding. Funding remained elusive for the next three years, and in the fall of 1989, the Nursing Graduate Student Association decided to form a committee to obtain funding for the doctoral nursing program. Nineteen graduate nursing students from the University of Alberta and the University of Calgary banded together to create the "Nursing PhD Program a Reality" group (NPPR). The group used a framework of planned change based on concepts found in the literature on power, politics, and political action.

Alberta↗
PubMedDate not supplied

Preceptors evaluating nursing students.

In this exploratory, descriptive survey of 295 nursing preceptors it was found that 98.3 per cent had evaluated nursing students. They cited numerous reasons as to why they should be involved in the evaluation process. Only 28.8 per cent had been taught to evaluate and 5.4 per cent had failed students. There is a discrepancy between how little preceptors are prepared for the evaluation role and how frequently they are expected to do so. Consequently, there is an onus on nurse educators to prepare clear evaluation forms, to assess students for suitability for preceptorship experiences, and to recognize evaluation as part of the preceptor's professional relationship with the student.

Adult↗
PubMedDate not supplied

Through the eyes of the preceptor.

This study highlights some of the issues for preceptors and assists in clarifying the role of preceptors, students and nurse educators. Through a survey of 295 nursing preceptors in the province of Alberta, it was found that most preceptors rated their orientation to their role as adequate to very adequate, the greatest advantage was re-examining their knowledge and the most common problem was having a student with poor nursing skills. Only 30 percent used nursing frameworks. The implications are: nursing educators need to take more responsibility in the areas of preceptor and student orientation, assess the student, preceptor and agency prior to placement, and understand that the preceptor may not be using a nursing framework. Nurses working as preceptors do have the advantage of knowledge since working with students can be a form of continuing education. This study highlights some of the issues for preceptors and assists in clarifying the role responsibilities of preceptors, students and nurse educators.

Attitude of Health Personnel↗